Position paper

Blood Transfusion - 1 2021 (January-February)

Heparin induced thrombocytopenia: position paper from the Italian Society on Thrombosis and Haemostasis (SISET)

Authors

Key words: platelets, thrombocytopenia, heparin, argatroban, danaparoid, fondaparinux
Publication Date: 2020-12-18

Abstract

Heparin induced thrombocytopenia (HIT) is a rare immune mediated adverse drug reaction occurring after exposure to heparin. It is a serious and potentially fatal condition, which may be associated with the development of arterial or venous thrombotic events. Although known for many years, HIT is still often misdiagnosed. Pre-test clinical probability, screening for anti-PF4/heparin antibodies and documentation of their platelet activating capacity are the cornerstones of diagnosis. However, both clinical algorithms and test modalities have limited predictive values and limited diffusion so that the diagnosis and management is challenging in the clinical practice. For this reason, there is an unmet need for novel rational non-anticoagulant therapies based on the pathogenesis of HIT.
The present paper reports the position of the Italian Society on Haemostasis and Thrombosis (SISET) in order to increase awareness of HIT among clinicians and other health care professionals and to provide information on the most appropriate management. 

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Authors

Rossella Marcucci - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Martina Berteotti - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Anna M. Gori - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Betti Giusti - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Angela A. Rogolino - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Elena Sticchi - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Agatina Alessandrello Liotta - Experimental and Clinical Medicine, University of Florence; Atherothrombotic Center, AOU Careggi, Florence, Italy

Walter Ageno - Department of Medicine and Surgery, University of Insubria, Varese, Italy

Erica De Candia - Department of Translational Medicine and Surgery, Catholic University of Rome, Rome, Italy; Department of Image Diagnostics, Radiotherapy and Haematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Paolo Gresele - Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy

Marina Marchetti - Department of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy

Marco Marietta - IRCCS “Ca’ Granda Maggiore” Hospital Foundation, “Angelo Bianchi Bonomi” Haemophilia and Thrombosis Center and “Fondazione Luigi Villa”, Milan, Italy

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